MUP 2016-00010
City of La Quinta
78-495 Calle Tampico
La Quinta, California 92253
PHONE: 760.777.7125 FAX: 760.777.1233
Office Use Only
Case Number Accepted Assigned 30 -Day
By To Deadline
L III �.
Notes:
MINOR USE PERMIT
APPLICATION
RECEIVED
JAN 2 1 2016
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT
Planning Stamp
JAN
21 2016
19 kf
cinc�F�r n aA
Sections A, B and C are to be completed by the applicant in their entirety and shall be
accompanied by all listed plans, studies, reports and exhibits listed in Section D unless
specifically waived bV the appropriate City staff member and noted thereon.
SECTION A - PROJECT INFORMATION
Project Name -
Project
Description,
APN #(s):
Site Address/
Location
General Plan:
Specific Plan:
Proposed Phases: •
— 1 oA ()► A lV1 6.
Zoning-
Proposed Use:
Related Cases:
3
Minor Use Permit Application Page 1 of 8
City of La Quinta • Planning Department - 760.777.7125 05.20.13
P:\Application Submittal Forms\Applications\MUP\MUP Application - 05.20.13.doc
SECTION B — STATEMENT OF OPERATIONS
The purpose of this form is to provide a detailed statement outlining the day-to-day operation of the
proposed project. Any approval related to this application will be based on the information provided
and will therefore be subject to the continued operation of the proposed project consistent with the
information provided. Please be aware that any activities beyond those described here may result
in the need to amend your use permit in the future, thus it is encouraged that the information
provided be based on the ultimate operation level of the proposed use.
Description of proposed use:
Hours of operation: l -,Lw Zldly Ld — 3,2i)A
Number of employees: n
List any other local, state or federal licenses or permits required:
I
Types of equipment and processes used: Wow e K-1 fr�Pyi - i 7 o . �Vi L , ✓Vlicrow►f(
Describe any hazardous materials used, stored, or produced on-site: /U vi
Describe any other special characteristics specific to the proposed use:
Minor Use Permit Application Page 2 of s
City of La Quinta • Planning Department • 760.777.7125 05.20.13
PAApplication Submittal Forms\Applications\MUP\MUP Application - 05.20.13.doc
•
SECTION C - APPLICANVOWNER INFORMATION
•
Applicant: �lp1'lle f'p, 2I-13
(Name) (Phone)
(Mailing Address) (Email)
Owner(s): C 'Y' 6 fz- ` j l cc
(' (Name) (Phone)
I �l L ` } �, =, 1."ice, 1 c>(C, - d �V//7
Architect:
Address)
(Email) -j r- i_ C ! 7 J c_ . 1 P r��'
(Name) (Phone)
(Mailing Address) (Email)
(California State License #)
A�Ilcant Certification
1 certify that I have read this application packet in its entirety and understand the City's
submittal and review process and the requirements for this application_ I further certify
that each application item submitted as part of this application is consistent with the
minimum required contents for that item as described in Section D of this application. I
understand and agree that if during the processing of the application, it is determined the
information does not strictly meet such standards or contains errors or omissions,
clarification andlor supplemental information may be required and the preparation of such
information may be considered, in the Planning Director's judgment, an unreasonable
delay and will result in a suspension of processing time limits in accordance with the
California Code of Regulations, Title 14, Section 15109.
c,
Applicant's Signature: t P �� Date: / 2C) /LQ
Print Name: t> ��►�P.Z __ _ _
Owner Certification
I certify under the penalty of the laws of the State of California that I am the property owner
of the property that is the subject matter of this application and I am authorizing and
hereby do consent to the filing of this application and acknowledge that the final approval
by the City of La Quinta, if any, may result in restrictions, limitations and construction
obligations being imposed on this real property. )
60
Owner/Authorized Agent Signature*.y' L Ij Date:
Print Name(s):
'An authorized agent for the owner must attach a notarized tetter of authorization from the legal property
owner. Any off-site work identified on the plans must be accompanied by a statement of authorization with a
notarized signature of the subject property owner.
Minor Use Permit Application Page 3 of 8
City of La Quinta • Planning Department - 760.777.7125 05.26.13
P Wppi-cation Submittal Forms\A.Pplicalfons\h<UP\MUP Apphcabcn - 05.20..3Aoc
CITY Of LA OUINTA
78-495 CALLE TAMPICO
LA OUINTA CA 92253
760-777-7000
41399861180891
Merchant IU: 3998011$0891
Ref il: (uk I
Sale
8592
DEBIT Entry Method: Swiped
Total: $ 200.00
0121/16 13:27:14
Inv 0: 012266 Aw Code: 167817
Transaction ID: 386021772340331
ilpprvd:Online Batch4:000325
Retrieval Ref.n: 602113132644
Trace Audit u: 132644
Net ID: 380
Settle Date: 0122
Customer COGr
THANK YOU
Date Paid: Thursday, January 21, 2016
Paid By: STEPHANIE
Cashier: SKH
Pay Method: DEBIT,
Printed: Thursday, January 21, 2016 1:26 PM 1 of 1 �r7
<YC iFI.A C
DESCRIPTION • o
PAID.
PermitTRAK
$200.00
MUP2016-0001 Address: 51849 AVENIDA CORTEZ Apn: 773152017
$200.00
MINOR USE PERMIT
$200.00
MINOR USE PERMIT 101-0000-42433 0
$200.00
TOTAL FEES PAIDR12266
$200.00
CITY Of LA OUINTA
78-495 CALLE TAMPICO
LA OUINTA CA 92253
760-777-7000
41399861180891
Merchant IU: 3998011$0891
Ref il: (uk I
Sale
8592
DEBIT Entry Method: Swiped
Total: $ 200.00
0121/16 13:27:14
Inv 0: 012266 Aw Code: 167817
Transaction ID: 386021772340331
ilpprvd:Online Batch4:000325
Retrieval Ref.n: 602113132644
Trace Audit u: 132644
Net ID: 380
Settle Date: 0122
Customer COGr
THANK YOU
Date Paid: Thursday, January 21, 2016
Paid By: STEPHANIE
Cashier: SKH
Pay Method: DEBIT,
Printed: Thursday, January 21, 2016 1:26 PM 1 of 1 �r7
<YC iFI.A C
January 28, 2016
0
Ms. Stephanie Hernandez
La Quinta Superfoods
51849 Avenida Cortez
La Quinta, CA 92253
•
•
uOlf'o'o d11) /
SUBJECT: MINOR USE PERMIT 2016-0001
COTTAGE FOOD OPERATION: 51-849 AVENIDA CORTEZ
Dear Ms. Hernandez:
The Community Development Department has reviewed your request for a Cottage
Food Operation (CFO) in a residence at 51849 Avenida Cortez. This letter is to notify
you that your request has been approved and is subject to the following Conditions of
Approval:
The cottage food operation shall be registered or permitted as a "Class A" or
"Class B" operation by the Riverside County Department of Environmental
Health, in accordance with Riverside County Ordinance 916 and Section 114365
of the California Health and Safety Code. Evidence of said registration or permit
issuance by the County shall be provided to the Community Development
Department prior to issuance of a City of La Quinta business license. All cottage
food operations require a City of La Quinta business license to be procured
subsequent to, and in compliance with, approval of the minor use permit
application and associated conditions of approval.
2. The cottage food operation shall be clearly incidental to the use of the structure
as a dwelling unit, and shall not create dust, noise or odors in excess of that
normally associated with residential use.
3. The cottage food operation shall not generate pedestrian or vehicular traffic in
excess of that normally associated with residential use.
4. No direct sales or service from the residence or property on which the residence
is located is permitted. The cottage food operation shall not be the point of
customer pickup or delivery of products or services, nor shall a cottage food
operation create greater vehicular or pedestrian traffic than normal for the
residential zoning district in which it is located.
78-495 Calle Tampico i La Quinta I California 92253 1 760.777.7000 1 www.La-Quinta.org
5. The cottage god operation shall be conducte0olely within the primary
residence.
6. Sign(s) identifying the cottage food operation are not permitted to be posted or
displayed on the premises, nor on or within anything located on the premises,
except as may be required by any federal, state, and/or local permitting agency.
Neither the dwelling nor the property shall be altered to appear other than a
residence, either by color, materials, construction, lighting, sounds, vibrations or
other characteristics.
7. No more than one (1) cottage food employee, as defined by California Health
and Safety Code Section 113758(b)(1), shall be employed by the cottage food
operation, not including any residing family or household member. ,
This minor use permit may be revoked for any violation of LQMC Section 9.60.115 or of
Section 114365 et seq. of the California Health and Safety Code. The city may, for
inspection purposes, access the permitted area of a private home where a cottage
food operation is located if the city has, on the basis of any complaint(s), reason to
suspect that the cottage food operation has violated the provisions of this Section
and/or California Health and Safety Code Section 114365 et seq. Furthermore, the' City
may also conduct routine periodic inspections to ensure compliance with the
provisions and conditions of the cottage food operation's minor use permit and City
business license.
This approval is final, but may be appealed by any interested party to the Planning
Commission, provided the required application forms and fee of $1,595.00 are filed
with this office within fifteen (15) days of the date of this letter.
Should you have any questions, please call me at (760) 777-7125.
SincRrely,
IkY-WUU, AICP
Principal Planner
2
• County of Riverside •
o
DEPARTMENT OF ENVIRONMENTAL HEALTH
www.rivcoeh.org
COTTAGE FOOD OPERATIONS (CFOs — Class A)
SELF CERTIFICATION CHECKLIST
The following.requirements are awlined in the Cottage Food Operations (CFO) regulations and are provided as mini wai standar&
of health and safetyfor the preparation of approved cottage foods in the home.
CFO BUSINESS NAME: OWNER NAME:
PHYSICAL ADDRESS: V CI ZIP:
F 2 n
FOR OFFICE USE
FA PR SR PE-, : . DISTRICT
Facility Requirements- Yes No
1. The CFO is located in a private dwelling where the CFO operator currently resides Ef 0
2. All CFO food preparation will take place in the private kitchen within that home. E ❑
3. Additional storage used for the CFO will be within the home.
a. If YES, is the room used exclusively for storage?
b. Specify the room(s) that will be used for storage? ,
4. Sleeping quarters are excluded from areas used for CFO food prepara ' n or storage. ❑
Zoning Requirements: Yes No
5. I have complied with the applicable zoning requirements for the CFO. ❑ ❑
6. 1 have attached documentation from the Planning office (If required) ❑ ❑
Employee and Training Requirements: Yes No
7. Have all persons preparing or packaging CFO products completed the CDPH food processor
Elcourse?
a. if YES, copies of certificates are attached. NJ ❑
b. If NO, complete course within 3 .months of CFO registration and forward a copy to the El 13Environmental Health Office where registration was completed.
8. The CFO has no more than 1 full-time equivalent employee? (Immediate family or household ❑
.members are not included.)
Sanitation Requirements: Yes No
9. Kitchen equipment and utensils used to produce CFO products are clean and maintained in a El.
good state of repair.
RECEIVED
JAN 21 2016
DES -13 (REV 7/15) CITY OF LA GUINTA
COMMUNITY nFWLApulcuT
10. All food contact surfaces, equipment, and utensils used for the preparation, packaging, or
handling of any CFO products shall be washed, rinsed, and sanitized before each use.
1"1. All food• preparation and food and equipment storage areas shall be maintained free of rodents
insects.
Food Preparation Requirements (includes packaging and handling):
Yes
❑
Eland
No
12.
Hand washing is required immediately prior to handling foods and after engaging in any
/
activity that contaminates the hands such as after using the toilet, coughing or sneezing, eating'
Q
❑
or smoking.
13.
Warm water, hand soap and clean towels are available for hand washing.
L�
❑
14.
All food ingredients used in the CFO products are from an approved source.
[�
❑
15.
Potable water shall be used for hand washing, ware washing and as an ingredient.
❑
16.
Is your water source a private water supply (well, spring, surface)?
❑
a. If YES, have you completed testing for bacteria, nitrate & nitrite?
El
❑
17.
Is your water source a public water system or community services district?
N
❑
a. If YES, what is the name of the system or district? CLQ j j�VGtll W Ci��r
During the preparation, packaging or handling of CFO products:
Yes
No
18.
Domestic activities such as family meal preparation, dishwashing, clothes washing or ironing,
❑"
kitchen clearting mguest entertainment' are excluded from the kitchen.
19.
Infants, small children (younger than 12 yr. old), or pets are excluded from the kitchen.
S/
❑
20.
Smoking is excl'ud'ed.
[�(
❑
21.
Any person with a contagious illness is prohibited from working in the CFO.
�/
❑
Labeling Requirements: Yes No
22. A copy of the label has been submitted to this Department for review and approval. ❑
23. I have attached a sample label. 10/ ❑
BY SIGNING BELOW YOU ARE CERTIFYING THAT YOU MEET THE REQUIREMENTS OF THE CALIFORNIA
HOMEMADE FOOD ACT, AB 1616 (GATTO), AS IT PERTAINS TO A "CLASS A" COTTAGE FOOD OPERATION. PRIOR
TO MAKING ANY CHANGES, I ACKNOWLEDGE THAT I MUST NOTIFY RIVERSIDE COUNTY DEPARTMENT OF
ENVIRONMENTAL HEALTH OF ANY INTENDED CHANGES TO THE ABOVE STATEMENT.
COTTAGE FOOD OPERATOR CHECKLIST COMPLETED AND SUBMITTED BY:
"
DATE:��r-1 1( Zb/ l.9 OWNER/OPERATOR: HJT
SIGNATURE 111UVERS UCENSEO/ EXP. DATE.
BUSINESS TELEPHONE: -��5 2-C 144 HOME TELEPHONE: MP
E-MAIL ADDRESS:
Page 2 of 2
• County of Riverside •
DEPARTMENT OF ENVIRONMENTAL HEALTH
www.rivcoeh.org
CALIFORNIA HOMEMADE FOOD ACT AD 1616
COT'T'AGE FOOD OPERATION (CFO)
REGISTRATION / PERMITTING FORM
CFO Business Name:
Baked Goods ❑ Dried Pasta
Date:
L- I SPS
Ground Chocolate ❑ Dry Baking Mixes
n 1 7.bi L12
CFO Physical Address:
Churros ❑ Waffle Cones
CFO City:
0
CFO ZIP:
1Sq9 64,Enic& QLYrf-e•Z
LUGu10f-r,_
ElNuts/Nut Mixes Dried Fruit
j1EE:1
gzz.s3
Owner Name: _
Owner Phone:
Owner Cell:
+P �lCc n i �--p r ►-la r�ct e. L
85�s 24 3 I yG g
❑
Dried Vegetarian -based Soup Mixes
Mailing Address (if different):
❑
Mailing City:
❑
Mailing ZIP:
Email Address:
❑
Flat icing
;Q -P e uJe l 1s ( (, c0 Y11
Popcorn balls
❑ Chocolate Covered Nonperishable Food
Website:
Confections Containing: ❑ Salted Caramel ❑ Fudge ❑ Marshmallow Bars ❑ Hard Candy ❑ Nuts
❑ Chocolate Covered Marshmallow
1. Categories:
"Class A" (Direct Sales Only) ❑ "Class B" (Direct& Indirect •Sales)
2. Prohibited Items: Initial if you agree to abide by the following:
I understand that foods containing cream, custard, or meat fillings are potentially hazardous and are NOT
ALLOWED. Only foods that are defined as "non -potentially hazardous" are approved for preparation by a Cottage
Food Operation (CFO). These are food items that do not require refrigeration to keep them safe from bacterial
growth that could be a cause of food -borne illness.
3. "Class A" Self Certification Checklist:
ET Checklist completed (Required for "Class A" CFOs Only)
4. Products:
Plegse check ALL of the itemsyou will be re arin and/or sellin .
DES -03 (REV 7/35)
Baked Goods ❑ Dried Pasta
❑ Honey ❑ Popcorn
❑
Ground Chocolate ❑ Dry Baking Mixes
❑ Mustard ❑ Vinegar
❑
Churros ❑ Waffle Cones
❑ Tortillas ❑ I Fruit Butter **
0
Dried Mole Paste ❑ Herb/Spice Blends
Q Pizelles Jams/Jellies**
Trail Mix El Fruit Tamales/Pies
ElNuts/Nut Mixes Dried Fruit
j1EE:1
Fruit Empanadas Nut Butters
E3Dried Tea Roasted Coffee
❑
Dried or Dehydrated Vegetables
Vegetable & Potato Chips Seasoning salt
❑
Dried Vegetarian -based Soup Mixes
❑ Buttercream Frosting with Non-PHF Ingredients
❑
Sweet Sorghum Syrup
❑
Granola/Cereals
❑ Marshmallows' that. do not contain eggs.
❑
Flat icing
❑
Popcorn balls
❑ Chocolate Covered Nonperishable Food
❑
Confections Containing: ❑ Salted Caramel ❑ Fudge ❑ Marshmallow Bars ❑ Hard Candy ❑ Nuts
❑ Chocolate Covered Marshmallow
Candy (i.e. Cotton Candy; Candied Apples, other candies provide descriptions/recipes):
**These items must comply with- standards described in Part 15d of Title 21 of the Code of Federal Regulations
htt ://www.accessdata.fda. ov/scripts/cdrh/cfdoes/cfCFR/CFRSearch.cfm?CFRPart=150
DES -03 (REV 7/35)
Example: 0
MADE .IN A,HOME.IOTC_ HEN
Permit -0:.=1.2345.
Issuedin county: County name
Chocolate Chip Cookies. With Walnuts
Sally's Treats
Anywhere, CA 925X0(*
Ingredients:.. Enriched flour (Wheat.flour, niacinT reduced.iron, thiamine,.
mononitrate, riboflavin and folic acid), butter (mile, salt),:chocolate,chips
(sugar; chocolate liquor, cocoa butter, butterfat (milk)), walnuts, sugar,
eggs, salt, artificial vanilla extract, baking soda.
Contains. Wheat,. eggs
,_mile,soy.,malnuts.
Net Wt. 3 oz. (85.049g)
* Full address required. for cottage food. operations. - n,otcurrently_listed in the local.
telephone directory
G. Water -Source: -
Please
ater-Sourrce:Please. identify the water source lobe used in Cottage Food Facility jCheck one box only)
ErNi ame of Public Water System or Community Services District: COOGI'k 1 l a VC 14
❑ If you use a Private Water Supply*, identify the source (well, spring, surface, etc.):
Private Water Supply: Water Quality Results
Check boxes below if initial water testing has been completed. All testing must be done at a State Certified Laboratory.
Attach a copy of the lab results and list the results in the space provided next to type of test.
❑ Bacteriological Test (quarterly):
❑ Nitrate Test (yearly):
❑ Arsenic (yearly, if applicable*):
❑. Fluoride. (once).
*Additional information may be required if food is prepared from a home with a private water supply — Check with
your local area office for details.
7. Disposal of Waste:
Please check what type of treatment is used to dispose of waste
911;ublic Sewer Service
❑ Private Septic System
In the event of septic system failure or plumbing problem, you are required to notify Riverside County Department of
Environmental Health immediately and discontinue all cottage food operations until repairs are completed and approval
to operate is issued.
Page 3 of 4
0
.0
-Made 'in -a tiome Xftchen
Peffnit-II.-
-tssued-in-County- 4ffiverside
,La-..Chii S.Wertaad-s-
.51849 Avenida Cortez.
La Quinta,, CA 92253 -
Ingredients: Gluten.. Free Oats,,. Banana, Sunflower. Seed Butter, Walnuts,
Coconut; Chia Seeds, Chocolate Chios, Agave, Cinnamon, Vanilla, Sea Salt
Contains: routs,
Net'Wt 6 oz- -(170-. I-gy
•
8. 'Food Processor Course: Initial if you agree to abide by the following:
Within 3 months of being approved to operate by the Environmental Health Department, please provide proof of
completion of the required California Department of Public Health (CDPH) food processor course*. Proof of
completion may be faxed to our Department at (951) 358-5017 (if possible please include area office and/or name of
inspector you have corresponded with).
* Riverside County Food Handler Course will meet this requirement: www.riveoeh.org
9. Employee: Initial if you agree to abide by the following:
I understand that I may not have more than one full-time equivalent cottage food employee, not including a family
member or household member of the cottage food operator, working within the registered or permitted area of a private
home where the cottage food operator resides and where cottage food products are prepared or packaged for direct,
indirect, or direct and indirect sale to consumers.
10. Gross Annual Sales: Initial if you agree to abide by the following:
1 understand that I will lose my CFO status and will need to become permitted in a commercial facility if my CFO
business exceeds the following gross annual sates figures for the calendar years in the following table:
Calendar Year Gross Annual Sales
In2013............................................................:...........$35,000
In'20I4 ...................................... ............................... $45,000
In 2015 and in subsequent years.................................$50,000
11. Delivery Limitations: Initial if you agree to abide by the following: SIP
I understand that I may accept orders and payments via the internet, mail or phone. However, atf "Class A" & "Class
B" CFO products must be delivered directly (in person) to the customer. The CFO products may not be delivered via
US Mail, UPS, FedEx or using any other indirect delivery method as this is regulated/subject to CDPH registration
and state and federal requirements.
12. Zonine Requirements: Initial if you agree to abide by the following: 3V
I understand that I must complywith all applicable zoning requirements for the jurisdiction in which F Five.
I have attached documentation from the Planning office (if required).
13.Owaer's Statement:
I, h(�Fni..P lry'rtard e2 agree to grant access to the local health department to conduct an
ins ecti n of my cottage food operation (mark one):
"Chris A". In the event of- a consumer complaint or reported Food -borne illness.
❑ "Class B": For regular annual facility inspections and in the event of a consumer complaint or reported food-
borne illness.
I, rP %�rD2 agree to notify Riverside County Department of Environmental Health
:prior. to 6uWUi iy ng_ my food. list,. type. of operation, and/or method. of selling,. distributing,, or otherwise .providing my
CFO products to the consumer or retailers, regardless of whether the product is sold, consigned, or given away.
'J hl aAJ-11C-
-�pl� n i Tr�arv� e2� I t
Owner's Signature Print Name bate
Page -4 of 4
OFFICE USE bNLY
AMT REC'D:.
DATE RECD.-
INf�OlCE#:
PAYMENT TYPE:. 'CASH I
EJ-CREDITIDEBIT 'CHECK . ' CHECK#:
DRIVERS LICENSE#::
EXPIRATTON DATE:
-'SAMPLE: LABEL RECVVED BY:
COPY OF'PLANNING APPROVAL RECEIVED BY.
ONSLTE.CFO L?VPECTION COA%!P
' $Y:_
DATE.
CFO APPROVED BY
=DATE:
FA#: PR#: <
R#.
PE#: F(i 3 % DistFicr: d�
Page -4 of 4
•
Food descriptions:
�i
5. Product Labeling: Initial if you agree to abide by the following:
For a detailed description, see the CDPH document "Labeling Requirements for Cottage Food Products." I
understand that all cottage food products must be property 'labeled in compliance with the Federal, Food, Drug, and
Cosmetic Act (21 U.S.C. Sec. 343 et-seq.) The -label mum include:
o The words "Made in a Dome Kitchen" in 12, point type.
• The name commonly used to describe the food product.
• The CFO business name, city, state and zip code of the cottage food 'operation which produced the cottage
food product. If the firm is not fisted in the current telephone directory then a street address must also be
declared. (A contact phone number or email address is optional but may be helpful for consumers to contact
your business.)
• The registration or permit number of the cottage food operation which produced the cottage food product and
in the case of "Class B" CFOs, the name of the county where the permit was issued.
• The ingredients of the food product, in descending order of predominance by weight, if the product contains
two or more ingredients.
• The net quantity (count, weight, or volume) of the food product. It must be stated in both English units
(pounds) and metric units (grams).
• A declaration on the label in plain language if the food contains any of the eight major food allergens such as
milk, eggs, fish, shellfish, tree nuts, wheat, peanuts, and soybeans. There are two approved methods
prescribed by federal law for declaring the food sources of allergens in packaged foods: 1) in a separate
summary statement immediately following or adjacent to the ingredient list, or 2) within the ingredient. list.
• If the label makes approved' nutrient content claims or health claims, the label must contain a "utrition
Facts" statement on the information panel.
o The use of the following eleven terms are considered nutrient content claims (nutritional
value of a food): free, low, reduced, fewer, high, less, more, lean, extra lean, good source, and
light. Specific requirements have been established for the use of these terms. Please refer to
the Cottage Food Labeling Guideline for more details.
o A health claim is a statement or message on the label that describes the relationship between
a food component and a disease or bealth-related condition (e.g., sodium and hypertension,
calcium and osteoporosis). Please refer to the Cottage Food Labeling, Guideline for more
details.
• Labels. must be legible and m English (accurately translated information m another language may accompany
• Labels, wrappers, inks, adhesives, paper, and packaging materials that come into contact with the cottage food
product by touching the product or penetrating the packaging must be food -grade (safe for food contact) and
not contaminate the food.
• Sample of label must be submitted prior to final approval.
Page 2 of 4
'50Ai43ie sns eied
eldoa eun apien6 Ione; wd 'uglslwa ap eq),a; el ap Hued a soup
sop iod opygA sa oslwiad a1s3 -wo:)vollexylaAialpuegpoo!-mmm
e eAeA Ione; iod'ope:)ynia:) aisa ivyuaA eied
;sopeoylua:) slyy, auouxlas A wo3-/4aleSpoojaielS
ua eivan:) ns a iapa»e uo:) eiseq oluawnwp aisa
ap leuonlpe eldoo eun iauaigo eied -eiaue:) eun ua asiepien6
apand A eiaialpq o eiauea oueiuei ap sa elafiei e -I •oivawow opoi
ua uq!3elelsw ns ua iaaweuuad aqap ope3ylua3 a1s3 ,ioslAiadns
ns a olan6gnua A egwe ap ope:)yluaa la aiedaS iapisianla
ap opepuo:) lap soivawyY ap ughelndlueW ap ughe3yiva:) ap
eiafiq el iauaigo eied oivalweuaAua la oilxa uo:) opeialdwo:) eHl
•spioni jeuosiad
inoA io; Ad6 a ulelai aseald -awenssl;o aiep ayi woy sieaA
oAv io; Allen sl ilwiad slgl wog uouenyianialpuegpo%mAkm
o1 o6 aseald'aimylim slyi A}liaA of
saieo,ywaD Aw,lxys pue woi'Ala;eSpoojale4S
uo iuno»e inoA olul )laeq bol Aldwls'ivawmop
slyl;o_Adoa leuoulppe up uleigo of sawppe ie>fiom noA aiayes
41!:)p4 ayi ie ulewai isnw amyuiaD slyl •ja6euew inoA of 1l aA16
pue anoge aimyluaa ayiano in: iwe160id.u0lieiyl4Ja7 ialpueH.
pooj Aiuno:) aplsianly ayi paieldwm Allryssa»ns aAey noA
isuoijejnjej6u0D
+�ePwQvm+aa w I .;_
........
AtaleSpocyalns
ON amming)
le [>f
�'Ip•�PWSePA�S £. 11P. Z i9
• e�ID�i4wA
'�ownas+wa�ww■
01 W1W14? OK u4dod mW}1P� Y�uYVwli,{I W Wm�4P9tiv1a W
zapuewa= alue4daS
41WHRu1)e lualuind104±puay119V+e�1'Bw?n1HOwi +QO wPW�3
81¢31j4a) Ja1PURN Pooi /4unO) aPISMAI ��oreer
ORDINANCE' NO; 587, SECTION 11
DISPLAY OF FOOD,HANDI,ER CERTIFICATE
ANY. PERSON. REOUIRED TO -HAVE .A FOOD HANDLER.CER-
TIFICATE SHALL IMMEDIATELY SUBMIT SUCH CERTIFICATE TO
HIS OR HER EMPLOYER.417 $104 BE THE'DUTY OF EVERY
SUCH EMPLOYER TO,KEEP, ON CONTINUOUS DISPLAY AT THE
PLACE OF EMPLOYMENT THE'FOOD=HANDLER CERTIFICATES
OF ALL SUCH PERSONS EMPLOYED.OR ENGAGED THEREIN, '
AND TO DISPLAY THEAtWITH.A CURRENT LIST OF ALL SUCH
PERSONS THEREIN ENGAGED OR EMPLOYED FOR COMPARI-
SON WITH SUCH CERTIFICATES. UPON TERMINATION OF EM-
PLOYMENT, EACH UNEXPIRED -CERTIFICATE SHALL BE
RETURNED TO THE HOLDER. Ire oyisl
Ampaomwuwgw Is
qm
arm
RIVERSIDE CTV/PALM SPRINGS FAC
DEPT OF ENVIRONMENTAL HEALTH
554 S. PASEO DOROTEA
O1 ,"12,,'20 16 000001
#2418 9:O7AN EVINA0006
774600
$117.00
CRD. CARD $177.0o
�jy ha vt I -Q t -;?v -;?v"d e Z - 6cc cru rn
l F hvevti4a- CB,-i-eZ
(�Ltlofz., Ciq 92253
f\) 6,,
P oom
Cc LH
c v
0 � � = � � (rl CSD � NETS
�.f
C.,00ri lz
6 -r -D A-ooU--A
v� I
6cz-
-
LAurjb2y
P -00,m
wiz oo�-t
3
Z
0
(Pr#aooM
K NS 7t -i
RECEIVED
JAN 21 2016
CITY OF LA QUIN v'A
6 Ev R_oo 1- +. COMMUNITY DEVELOPMEN
Z
F,
�-��{'1av1 �� -�Q�-►'lav��i�2 - l�c Cyu,v� IL.S'�,cpv✓fL�-��dSfc
vFn
N 21 2016
OF LA QUINTA
UNITY DEVELOPMENT
•
'j I?sgq *I, A ido., (�br 2
�cW o
RECEIVED
JAN 21 2016
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT